title: The level of physical exercise is associated with self-reported health status (EQ-5D) in adults with congenital heart disease.
abstract: BACKGROUND
  The prognosis in adults with congenital aortic valve disease is usually favourable; nevertheless, a number of medical and social factors might hamper long-term prognosis and quality of life. With a focus on physical exercise level, data from the Swedish National Registry on Congenital Heart Disease (SWEDCON) were analysed and variables associated with health-related quality of life in adults with congenital aortic valve disease were identified.
  
  
  METHODS
  In this registry study, SWEDCON was searched for adult patients with isolated congenital aortic valve disease and valid EuroQol-5Dimensions health questionnaire (EQ-5D) data.
  
  
  RESULTS
  This study identified 315 patients. The majority (n = 202, 64%) reported best possible health status (EQ-5D(index) = 1) whereas 113 (35%) reported some impairment (EQ-5D(index) < 1) with mean EQ-5D(index) 0.73 ± 0.17. In a multivariate logistic regression model, self-reported physical exercise > 3 h/week was independently associated with best possible health status (EQ-5D(index) = 1; p = 0.013). Moreover presence of cardiovascular symptoms (p < 0.001), active smoking (p = 0.002), history of valve surgery (p = 0.017), low educational level (p = 0.022), and higher systolic blood pressure (p = 0.029) were independently associated with impaired health status (EQ-5D(index) < 1).
  
  
  CONCLUSIONS
  Physical exercise >3 h/week was, as a single variable, associated with best possible health status in adults with congenital aortic valve disease. In contrast, a number of medical and social factors are associated with worse self-reported health status. Among these, symptoms, smoking, and educational level are potential targets for modification and intervention. There is a need for studies investigating the effect of increased level of physical exercise in patients with congenital aortic valve disease.
authors.affiliation: Umeå University, Umeå, Sweden.
authors.forename: Camilla
authors.initials: C
authors.lastname: Sandberg
authors.affiliation: University of Gothenburg, Gothenburg, Sweden.
authors.forename: Karl Gunnar
authors.initials: KG
authors.lastname: Engström
authors.affiliation: University of Gothenburg, Gothenburg, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Dellborg
authors.affiliation: Lund University, Lund, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Thilén
authors.affiliation: Umeå University, Umeå, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Wadell
authors.affiliation: Umeå University, Umeå, Sweden bengt.johansson@medicin.umu.se.
authors.forename: Bengt
authors.initials: B
authors.lastname: Johansson
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000503:physiopathology; D000082882:Bicuspid Aortic Valve Disease; D015444:Exercise / Q000502:physiology*; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006330:Heart Defects, Congenital / Q000503:physiopathology*; D006349:Heart Valve Diseases / Q000151:congenital / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology; D012042:Registries / Q000706:statistics & numerical data; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adult congenital heart disease; EQ-5D; aortic regurgitation; aortic stenosis; bicuspid aortic valve